Γράφει η κα. Γιοβάννη Αγγελική, Γενική Χειρουργός, Επιστημονική Συνεργάτης Κλινικής ΆΝΑΣΣΑ
Την υγεία τους βρήκαν παχύσαρκοι πολίτες, στο Τμήμα Αντιμετώπισης Μεταβολικών Νοσημάτων και Παχυσαρκίας της Κλινικής Άνασσα στο Βόλο. Μετά από λαπαροσκοπική επέμβαση, οι ασθενείς έχασαν το υπερβάλλον βάρος, στο διάστημα που ακολούθησε, ενώ η καθημερινότητα τους απαλλάχτηκε από χάπια για συνοδά νοσήματα και η ψυχολογία τους ξαναβρήκε την χαμένη της αυτοεκτίμηση.
As the general surgeon in charge of the cognitive object explains Angeliki Giovanni,eligible for surgery are those patients who have a Body Mass Index (BMI) of 35 with accompanying diseases such as diabetes mellitus, respiratory failure, hyperlipidemia, etc., or those with BMI over 40.
Patients are examined by a range of doctors and health professionals such as a pulmonologist, cardiologist, psychiatrist, endocrinologist, pathologist, gastroenterologist, psychologist and nutritionist. After their health check and committee review, the surgeries are scheduled. During this time, the patients participate in a psychotherapy program and prepare for their post-operative condition so that their weight loss is maintained.
The choice of the type of surgery is jointly decided by doctors and patients. After laparoscopic surgery, patients return to their activities much faster compared to patients undergoing open surgery. The vast majority of patients undergoing surgery are women by a ratio of 5 to 1 compared to men, and patients range in age from 16 to 65.
Indicatively, for the positive results of the operations, examples are given of two young patients who, in addition to morbid obesity, also presented concomitant diseases which were also treated:
a) 46-year-old obese man underwent an elongated gastrectomy and managed to lose 39 kg in 6 months, dropping his weight to 97 kg from 136. He got rid, apart from the extra pounds, and from hypertension and hyperlipidemia
b) 34-year-old woman weighing 126 kg lost 18 kg in the first 20 days after the operation and significantly improved hyperlipidemia and diabetes
Weight loss is maintained for life with the continuous support of patients from psychotherapists, dieticians and exercise. By losing extra pounds, diseases such as diabetes mellitus, dyslipidemia, hypertension and obstructive apnea, hormonal homeostasis, musculoskeletal problems, while chronic venous insufficiency and lymphedema of the lower limbs and abdomen show a marked improvement.
Clinically severe obesity is likely to become an epidemic in the 21st century, and the problem will mainly affect young children. The causes of this disease are a sedentary lifestyle, fast food, lack of information on nutrition issues. It causes a series of psychological, respiratory, cardiovascular, endocrine, etc. problems.
Since 2016, the International Guidelines published in Diabetes Care, the official medical journal of the American Diabetes Association and adopted by more than 60 scientific societies in the world ( and by the Hellenic Diabetes Association), mark a new era in the treatment of type 2 diabetes. In 1997, it was announced that surgery cures diabetes in 81% of cases and reduces the death rate from 4.5% to 1% compared to obese diabetic patients who chose not to undergo surgery.
Patients who underwent gastric bypass surgery showed an immediate improvement in diabetes and stopped their medication either immediately or after a while after their blood sugar levels had already been fully restored. In other words, the improvement they presented did not depend on the weight loss, but was due to the metabolic and hormonal changes directly caused by the operation itself.
On the contrary, in patients who underwent restrictive type operations (gastric band, gastric sleeve) the improvement was exclusively associated with weight loss and in case of regaining the lost weight they presented a recurrence of diabetes.
Success rates are 83% to 90%. This means that eight out of ten patients stop their diabetes medication or insulin.